Lecture 14 - paediatric physiotherapy - EBP

Question 1

Define natural recovery and clinical course

Answer 1

natural = what happens to status of condition among children who have no treatment

clinical = status of the condition/injury among children who receive no treatment

Question 2

what are the 5 steps to a prognosis

Answer 2

ask answerable questions
track down evidence
do you believe the study of prognosis
what is the study telling you 
apply the results to your patient

Question 3

form a clinical question about a prognostic factor

Answer 3

for an obese (prognostic factor) 12 year old boy with a stress fracture of the tibia (population), what is the likelihood (risk)of returning to soccer within (outcome) 3 months time (time frame)

Question 4

what is the difference between a retrospective and prospective study

Answer 4

retrospective - looks back at old information and interprets

prospective - follows new information

Question 5

Define inception cohort and survival cohort

Answer 5

survivor - a sample of the population of all people with a condition, including those with long standing problems

inception = a sample of the population taken at a uniform point in the course of the disease

Question 6

what are the formulas for continuous and dichotomous outcomes

Answer 6

continuous = CI = mean +- 3 x SD/Square root of 2n

dichotomous = %risk +- 100/square root 2n

Question 7

Dichotomous Odds rations formula

Answer 7

example

relapsed/non-relapsed - 16/5 - non-compliant with treatement
relapsed/non-relapsed - 0/30 - compliant

(16. 5/5.5)/(0.5/30.5) = 183 = 183 x more likely to have relapse if patients parents are non compliant
* remember if a value is 0, add 0.5 to all numbers

Question 8

Define odds ratio

Answer 8

odds of the event happening in the group with the prognostic factor considered with odds of the event happening in the group without it

OR>1 = more likely to occur in group with P factor
OR=1 equally likely
OR<1 = less likely